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Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study

BACKGROUND: We compared the methods of electrocardiogram (ECG) and X‐ray localization of the peripherally inserted central catheter (PICC) tip position, in order to find a more convenient, practical, and safe method. OBJECTIVE: To investigate the value of applying electrocardiographic localization o...

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Autores principales: Chai, Yong‐Hong, Han, Su‐Ya, Zhu, Yu‐Xin, Hou, Jin‐Jie, Guan, Xiao‐Hui, Yin, Xin‐Xin, Zhang, Feng‐Ying, Qiao, Qin‐Zeng, Han, Ling‐Min, Li, JiangHua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916555/
https://www.ncbi.nlm.nih.gov/pubmed/34951713
http://dx.doi.org/10.1111/anec.12918
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author Chai, Yong‐Hong
Han, Su‐Ya
Zhu, Yu‐Xin
Hou, Jin‐Jie
Guan, Xiao‐Hui
Yin, Xin‐Xin
Zhang, Feng‐Ying
Qiao, Qin‐Zeng
Han, Ling‐Min
Li, JiangHua
author_facet Chai, Yong‐Hong
Han, Su‐Ya
Zhu, Yu‐Xin
Hou, Jin‐Jie
Guan, Xiao‐Hui
Yin, Xin‐Xin
Zhang, Feng‐Ying
Qiao, Qin‐Zeng
Han, Ling‐Min
Li, JiangHua
author_sort Chai, Yong‐Hong
collection PubMed
description BACKGROUND: We compared the methods of electrocardiogram (ECG) and X‐ray localization of the peripherally inserted central catheter (PICC) tip position, in order to find a more convenient, practical, and safe method. OBJECTIVE: To investigate the value of applying electrocardiographic localization of the PICC tip position in critically ill patients with advanced cancer in Hebei Province, China. METHOD: Enrolled 137 advanced cancers requiring PICC placement. The position of the catheter tip was localized with the bedside electrocardiogram in real time. Then, the localization was performed using a chest X‐ray (the gold standard). The accuracy of electrocardiographic location was checked. RESULTS: Specific P waves were observed in 130 patients. No change in the P waves was observed for the remaining seven patients. The age of the latter group of patients was more advanced (87.29 [5.15] years), a significant difference to that of the 130 patients with specific P waves (71.58 [14.84] years) (t = −6.704, p < .001). Specific P waves not only involve ascendance in P waves but also ascendance in QRS waves. CONCLUSIONS: The use of an ECG to localize the PICC tip in critically ill patients with advanced cancer may replace the unnecessary use of chest X‐rays. Specific P waves not only involve an increase in P waves but also an increase in QRS waves. If there is no change in the P wave, a chest X‐ray film must be obtained. In elderly patients, because there is a possibility of catheter tip malposition, a comprehensive evaluation should be performed before surgery.
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spelling pubmed-89165552022-03-18 Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study Chai, Yong‐Hong Han, Su‐Ya Zhu, Yu‐Xin Hou, Jin‐Jie Guan, Xiao‐Hui Yin, Xin‐Xin Zhang, Feng‐Ying Qiao, Qin‐Zeng Han, Ling‐Min Li, JiangHua Ann Noninvasive Electrocardiol Original Articles BACKGROUND: We compared the methods of electrocardiogram (ECG) and X‐ray localization of the peripherally inserted central catheter (PICC) tip position, in order to find a more convenient, practical, and safe method. OBJECTIVE: To investigate the value of applying electrocardiographic localization of the PICC tip position in critically ill patients with advanced cancer in Hebei Province, China. METHOD: Enrolled 137 advanced cancers requiring PICC placement. The position of the catheter tip was localized with the bedside electrocardiogram in real time. Then, the localization was performed using a chest X‐ray (the gold standard). The accuracy of electrocardiographic location was checked. RESULTS: Specific P waves were observed in 130 patients. No change in the P waves was observed for the remaining seven patients. The age of the latter group of patients was more advanced (87.29 [5.15] years), a significant difference to that of the 130 patients with specific P waves (71.58 [14.84] years) (t = −6.704, p < .001). Specific P waves not only involve ascendance in P waves but also ascendance in QRS waves. CONCLUSIONS: The use of an ECG to localize the PICC tip in critically ill patients with advanced cancer may replace the unnecessary use of chest X‐rays. Specific P waves not only involve an increase in P waves but also an increase in QRS waves. If there is no change in the P wave, a chest X‐ray film must be obtained. In elderly patients, because there is a possibility of catheter tip malposition, a comprehensive evaluation should be performed before surgery. John Wiley and Sons Inc. 2021-12-24 /pmc/articles/PMC8916555/ /pubmed/34951713 http://dx.doi.org/10.1111/anec.12918 Text en © 2021 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Chai, Yong‐Hong
Han, Su‐Ya
Zhu, Yu‐Xin
Hou, Jin‐Jie
Guan, Xiao‐Hui
Yin, Xin‐Xin
Zhang, Feng‐Ying
Qiao, Qin‐Zeng
Han, Ling‐Min
Li, JiangHua
Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title_full Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title_fullStr Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title_full_unstemmed Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title_short Electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: An application study
title_sort electrocardiographic localization of peripherally inserted central catheter tip position in critically ill patients with advanced cancer: an application study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916555/
https://www.ncbi.nlm.nih.gov/pubmed/34951713
http://dx.doi.org/10.1111/anec.12918
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